Disease agents: Epidemiological perspectives Specific Objectives 1.Give general description and classification regarding agents of diseases 2.

Discuss the factors contributing to disease transmission.

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CLASSIFYING DISEASES
Acute Diseases Acute diseases are those conditions in which the peak severity of symptoms occurs within three months (usually sooner), and recovery in those who survive is usually complete Chronic Diseases Chronic diseases or conditions are those in which symptoms continue longer than three months and in some cases for the remainder of the persons life. Recovery is slow and sometimes incomplete.
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CLASSIFYING DISEASES (contd.)

Communicable (Infectious) Diseases Diseases for which biological agents or their products are the cause and which are transmissible from one individual to another The disease process begins when the causative agent is able to lodge and grow or reproduce within the body The process of lodgment and growth of a microorganism or virus in the host is termed infection :

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CLASSIFYING DISEASES (contd.)

Non-communicable (Noninfectious) Diseases/Illnessses Those diseases or illnesses that cannot be transmitted from an infected person to a susceptible, healthy one Several, or even many, factors may contribute to the development of a given non-communicable health condition The contributing factors may be genetic, environmental, or behavioral in nature

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Classification of Diseases
Types of Diseases_Examples
Acute Diseases
Communicable
Common cold, mumps, measles, pertussis, typhoid fever, flu

Non-communicable
Appendicitis, poisoning, trauma

Chronic Diseases
Communicable
Lyme disease, tuberculosis, AIDS, syphilis,

Non-communicable
Diabetes, coronary heart disease, osteoarthritis, hypertension

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Kochs Postulates
Koch developed four criteria to demonstrate that a specific disease is caused by a particular agent. 1. The specific agent must be associated with every case of the disease. 2. The agent must be isolated from a diseased host and grown in culture. 3. When the culture-grown agent is introduced into a healthy susceptible host, the agent must cause the same disease. 4. The same agent must again be isolated from the infected experimental host.
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6Images from Public Domain Sources ,

Infectious Disease Agents

Most infectious agents that cause disease are microscopic in size and thus, are called microbes or microorganisms. Different groups of agents that cause disease are: Bacteria Viruses Protozoa Fungi Helminths (Animals)
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Infectious Diseases Throughout History

Infectious agents have probably always caused disease in humans. Smallpox has been described in ancient Egyptian and Chinese writings and may have been responsible for more deaths than all other infectious diseases combined. There is evidence that malaria and poliomyelitis have existed since ancient times. In the 14th Century, the bubonic plague, or Black Death, killed about 20 million people in Europe alone. In the 20th Century, the 1918 influenza may have killed up to 50 million people worldwide Close to 20 million people have died of AIDS to date.

Courtesy of CDC

Recreated 1918 Influenza virions. The 1918 Spanish flu killed more than 500,000 people in the United States and up to 50 million worldwide.
8Images from Public Domain Sources ,

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Epidemiology : TRIADS

TRIAD of Causation

HOST

ENVIRONMENT

AGENT

The environment plays a key role in host agent interaction. If the environment favors the host, disease occurrence will be prevented. If the environment favors the agent, the disease will occur.
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TRIAD OF CAUSATION

LIVING AGENTS Plant origin Animal origin Metazoa, protozoa, fungi, yeasts, bacteria, rickettsiae, mycoplasma viruses etc.

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AGENT
NON-LIVING AGENTS

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(force)

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Factors related to infectious disease agents

Pathogenicity
Ability to initiate the disease

And it is an aggressive factor of the agent :

Includes: Transmissibility Infectivity virulence
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Transmissibility or Communicability
Ability to grow profusely Ability to be shed in large numbers Influenza virus multiply rapidly & shed through secretions in large amount

Viability
Ability to survive adverse environ mental conditions eg; smallpox virus
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Infectivity
Ability to breach the defense mechanism of new host

M . leprae has low infectivity while measles virus has high infectivity

Secondary attack rate is a way of measuring infectivity

The number of secondary cases divided by total number of susceptible persons

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Virulence
Ability to produce severe pathologic reactions and severe clinical manifestations HIV virus produce severe pathologic reactions ultimately leading to death

The number of deaths cases suffering from that disease

/ total number of
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Toxigenicity
Ability to produce exotoxin or endotoxin

Diphtheria, tetanus and staph aureus produce exotoxins

Salmonella and yersinia produce endotoxins E coli produce enterotoxins
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Invasiveness
Ability to invade and spread in tissues Pneumococci and meningococci are highly invasive bacteria Bacillus cereus is not invasive that it acts through toxins Salmonella typhi is highly invasive while salmonella paratyphi is less invasive
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Tissue tropism /selectivity

Ability to live and exerts its ill effects on specific tissues of the body Rabies virus has tropism to nerve ts Polio virus to the anterior horn cells Plasmodium species to the RBCs Mycobacterium to the tissues with high oxygen supply
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Immunogenecity
Ability to stimulate the host and produce specific immunity Tubercle bacilli initiate the production of cell mediated immunity

Salmonella stimulates specific humoral antibodies Polio virus produces both local and systemic antibodies
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Host range
Ability to survive in various host characteristics Agents with Wide host range are difficult to control than those which can survive in only man Japanese B encephalitis has a very wide host range Syphilis occurs in man only
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Genetic Stability/mutability
Ability to change or mutate its genetic characteristics Agents with high mutability are difficult to control than those which can not easily change their genetic make-up Influenza virus can mutate several times within a decade Small pox virus is the most stable virus
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Susceptibility/ resistance
To chemotherapeutic agents Antibiotics disinfectants The more susceptible, the easier to control / kill the agents Emergence of resistance strains hinders the success of control measures
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Pattern of transmission
Chain of the infectious process

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The infectious disease agents may be of exogenous or endogenous origin

Intensity of aggressiveness

Duration of exposure
The more the intensity, the lesser the duration required to produce ill health
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